泮托拉唑、克拉霉素、阿莫西林三联治疗十二指肠溃疡30例疗效

目的观察泮托拉唑、克拉霉素、阿莫西林三联疗法对十二指肠溃疡(DU)的疗效。方法将60例经电子胃镜检查确诊为DU活动期,并经活检取材行快速尿素酶试验确定幽门螺旋杆菌(HP)阳性的患者随机分为两组:泮托拉唑三联治疗组和奥美拉唑三联对照组各30例。两组均先予三联治疗:泮托拉唑胶囊40mg或奥美拉唑胶囊20mg 克拉霉素片500mg 阿莫西林胶囊1000mg,每天2次,连续7d,然后单独给予泮托拉唑40mg,每日1次,或奥美拉唑20mg每日1次,连续3周。治疗共4周后复查胃镜并检测HP,观察溃疡治愈率、HP根治率及不良反应率。结果泮托拉唑和奥美拉唑组治愈率分别为93.3%、90%;HP根除率90%、86.7%,两组差异均无显著性(P>0.05)。不良反应率泮托拉唑组低于奥美拉唑组(P<0.05),有显著差异性。结论泮托拉唑、克拉霉素、阿莫西林三联治疗DU效果好、不良反应少。     

思密达辅助治疗消化性溃疡疗效观察

目的为了观察思密达与泮托拉唑联合用药对消化性溃疡的疗效和安全性。方法56例消化性溃疡患者随机分为2组,抗Hp治疗l周后,治疗组予泮托拉唑+思密达治疗4周,对照组仅予泮托拉唑治疗4周后复查胃镜,并进行疗效判断。结果治疗组疗效优于对照组2组疗效有显著性差异。治疗组在缩短病程,提高疗效方面优于对照组。结论思密达辅助治疗消化性溃疡是有效和安全的方法。     

埃索美拉唑治疗幽门螺杆菌阳性老年人消化性溃疡——附39例临床观察

目的观察埃索美拉唑对幽门螺杆菌(H.pyloriHp)阳性老年消化性溃疡病的治疗效果。方法选取39例Hp阳性,年龄在60岁以上的消化性溃疡病人,随机分成2组。第1组予以埃索美拉唑20mg,阿莫西林1000mg,呋喃唑酮100mg,每日2次,疗程1周。第2组给予奥美拉唑20mg,每日2次,疗程3周,在第1周同服阿莫西林1000mg,呋喃唑酮100mg,每日2次。观察各组病人症状缓解情况、Hp根除率、不良反应及溃疡愈合率。结果各组病人症状在1～4d内缓解,Hp根除率第1组、第2组分别为89.47%、90.0%。溃疡愈合率分别为89.47%、90.0%。结论埃索美拉唑治疗老年性消化性溃疡,Hp根除率高,疗程短,顺从性和耐受性好。     

以左氧氟沙星为基础的三联疗法根除幽门螺杆菌的临床观察

目的探讨以左氧氟沙星为基础的三联疗法根除幽门螺旋杆菌(HP)的疗效。方法50例消化性溃疡的患者随机分成2组,治疗组:第1周左氧氟沙星0.2(2次/d)+甲硝唑0.4(2次/d)+兰索拉唑30mg(1次/d)。对照组:第1周克拉霉素0.5(2次/d)+甲硝唑0.4(2次/d)+兰索拉唑30mg(1次/d);2组均于第8天开始单独口服兰索拉唑30mg,1次/d。治疗共3周完毕后停药,进行HP检查,结果治疗组,对照组根除HP分别为92%,88%,2组相比,差异均无统计学意义(P>0.05),未发生严重不良反应。结论以左氧氟沙星为基础的三联用药能安全有效根除HP,治疗消化性溃疡疗效佳。     

泮托拉唑钠与奥美拉唑治疗脑出血并发应激性溃疡出血疗效比较

目的对应用泮托拉唑钠和奥美拉唑治疗脑出血并发应激性溃疡出血的疗效进行对比观察。方法随机将96例患者分为泮托拉唑组和奥美拉唑组,在分别治疗5d后,评价疗效并进行对比观察。结果两组患者均有明显止血效果,泮托拉唑组用药48h显效率67.39%,总成功率95.65%,奥美拉唑组分别为40.00%和76.00%,泮托拉唑组疗效显著高于奥美拉唑组(P<0.05)。结论泮托拉唑治疗脑出血并发应激性溃疡疗效确切,无明显不良反应,且疗效明显优于法莫替丁,值得临床推广应用。     

奥美拉唑三联疗法治疗幽门螺杆菌阳性消化性溃疡疗效观察

目的观察奥美拉唑三联疗法治疗幽门螺杆菌阳性消化性溃疡的疗效。方法56例消化性溃疡患者,随机分为治疗组和对照组。对照组采用奥美拉唑治疗1周,治疗组采用奥美拉唑、克拉霉素、阿莫西林治疗4周。结果治疗组消化性溃疡有效率为93.3%,对Hp清除率为90.0%,复发率为12.5%;对照组有效率为76.9%,对Hp清除率为65.4%,复发率为21.4%。结论奥美拉唑三联疗法对溃疡有较高的愈合率、Hp清除率及较低的复发率。     

兰索拉唑三联治疗HP阳性消化性溃疡疗效观察

目的观察兰索拉唑三联疗法对幽门螺旋杆菌(HP)阳性的消化性溃疡的疗效。方法将符合条件的患者随机分为2组,治疗组应用兰索拉唑,克拉霉素,阿莫西林三联治疗1周,之后兰索拉唑3周疗法。对照组应用奥美拉唑,甲硝唑,阿莫西林三联1周,之后奥美拉唑3周疗法。疗程结束1个月后进行胃镜和HP检查。结果治疗组与对照组溃疡愈合率分别为93.3%和90%,,HP根除率分别为90%和73.3%。结论兰索拉唑三联疗法确切,症状缓解迅速,依从性好。     

埃索美拉唑与奥美拉唑治疗Hp阳性十二指肠球溃疡临床对比研究

目的比较埃索美拉唑与奥美拉唑治疗幽门螺杆菌(H.pylori,Hp)阳性十二指肠球溃疡临床疗效。方法将我院2004年9月至2007年12月92例经内镜证实的Hp阳性的十二指肠球溃疡患者随机分为两组。埃索美拉唑组(46例):给予埃索美拉唑20mg,每日1次,共4周,阿莫西林1000mg,呋喃唑酮100mg,两种抗生素均为每日2次,共7d。奥美拉唑(46例)组:给予奥美拉唑20mg,每天1次,共4周,阿莫西林1000mg,呋喃唑酮100mg,每天2次,共7d。分别观察两组患者服药后第1天24h胃内PH,服药后第1天腹痛缓解率,疗程结束4周后复查胃镜并检测Hp,观察Hp根除率,溃疡愈合率及用药后的不良反应等。结果按治疗方案用药后,埃索美拉唑组第1天平均24h胃内pH高于奥美拉唑组(P<0.01),两组间差异有统计学意义。埃索美拉唑组第1天腹痛缓解率(63.04%)高于奥美拉唑组(30.43%),P<0.01,两组间差异有统计学意义。埃索美拉唑组和奥美拉唑组Hp根除率分别为91.30%和86.96%(P>0.05),溃疡愈合率分别为100%和95.65%(P>0.05),差异无统计学意义。两组用药后的不良反应均少,有较好的安全性。结论本组临床资料显示,在抑制胃酸分泌的速度和强度以及缓解临床症状速度方面,埃索美拉唑优于奥美拉唑,在溃疡愈合率和抗Hp活性方面效果相当。     

消化性溃疡的临床治疗研究

目的探讨奥美拉唑、阿莫西林、左氧氟沙星联合使用在用于消化性溃疡治疗中的临床疗效研究。方法选择我院幽门螺杆菌(HP)阳性消化性溃疡患者50例,采用双盲法随机分为对照组和治疗组,每组各25例,对照组:法莫替丁、左氧氟沙星、阿莫西林联合应用治疗,治疗组:奥美拉唑、左氧氟沙星、阿莫西林联合应用治疗。4周后停药进行胃镜检查,对溃疡有效率、HP根除情况、症状缓解情况率和不良反应进行观察比较。结果治疗组的溃疡总有效率为92%,HP根除率为96%,对照组的为76%和80%,2组治疗效果差异显著,具有统计学意义(P<0.05)。结论奥美拉唑、阿莫西林、左氧氟沙星联合使用在治疗消化性溃疡中疗效显著,不良反应少。     

埃索美拉唑、阿莫西林、克拉霉素三联疗法治疗消化性溃疡的疗效观察

目的分析埃索美拉唑、阿莫西林、克拉霉素三联疗法治疗消化性溃疡的疗效。方法 80例消化性溃疡患者随机分成治疗组和对照组2组各40例。治疗组口服克拉霉素、埃索美拉唑、和阿莫西林胶囊,对照组口服甲硝唑、洛赛克和阿莫西林胶囊,4周后观察疗效。结果治疗组有效率为95.0%,对照组有效率为75.0%,2组总有效率比较有显著性差异(P<0.05)。治疗组的Hp根除率也明显高于对照组(P<0.05)。2组治疗后查肝肾功能、血尿常规无明显异常变化。结论埃索美拉唑、阿莫西林、克拉霉素三联疗法治疗消化性溃疡疗效确切,不良反应少,安全性好,值得临床推广应用。     

雷贝拉唑、呋喃唑酮、阿莫西林三联治疗幽门螺杆菌相关消化性溃疡的临床观察

目的观察雷贝拉唑、呋喃唑酮、阿莫西林三联疗法对幽门螺杆菌相关消化性溃疡的疗效。方法63例幽门螺杆菌相关消化性溃疡患者分为两组,对照组(31例)给予奥美拉唑、克拉霉素、阿莫西林三联治疗1周后,继续单用奥美拉唑3周。实验组(32例)给予雷贝拉唑、呋喃唑酮、阿莫西林三联治疗1周。治疗后不同时间点比较两组症状改善情况;治疗结束4周后,观察幽门螺杆菌清除及溃疡治愈情况。结果治疗1周后,实验组症状缓解率明显高于对照组,有显著差异性(P<0.05);而其余时间点两组无明显区别。治疗结束4周后,实验组在幽门螺杆菌清除率及溃疡治愈率方面与对照组无显著差异性(P>0.05)。结论雷贝拉唑、呋喃唑酮、阿莫西林三联治疗幽门螺杆菌相关消化性溃疡,具有症状改善迅速、治疗周期短、幽门螺杆菌根除率、溃疡治愈率与传统三联疗法相似的优点。     

Healing,Antioxidant and Cytoprotective Properties of Indigofera truxillensis in Different Models of Gastric Ulcer in Rats

The present study evaluated the antiulcerogenic activity and mechanisms of the aqueous (AqF 100 mg/kg) and ethyl acetate (AcF 50 mg/kg) fractions from Indigofera truxillensis leaves. This dose was selected to assess its activity on ulcer healing and its action on gastric acid and mucus secretion, prostaglandin production and antioxidant enzyme activity (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and glutathione reductase (GSH-Rd)). Gastric ulcer was induced by absolute ethanol. Antisecretory action, mucus and prostaglandin production, healing and antioxidant enzyme activities were evaluated for both fractions. AqF and AcF significantly inhibited the gastric mucosal damage caused by ethanol. This effect was statistically significant at 100 and 50 mg/kg compared with the vehicle. Neither fraction interfered with gastric secretion. AcF increased the PGE₂ production, and both fractions increased mucus production. l-NAME did not alter the gastroprotection exerted by the fractions, but N-ethylmaleimide attenuated only AcF. In the ischemia/reperfusion model both fractions inhibited the mucosal damage. AcF increased SOD, GSH-Px and GSH-Rd activity, but AqF increased only SOD and GSH-Px. In the acetic acid-induced ulcer model AcF only accelerated ulcer healing. These results showed that Indigofera truxillensis acted as a gastroprotective agent, stimulating protective factors and antioxidants enzymes.     

Helicobacter connections

After preliminary studies in 1981, Marshall and Warren conducted a study in which the new bacterium Helicobacter pylori was cultured. In that series, 100 % of 13 patients with duodenal ulcer were found to be infected. The hypothesis that peptic ulcer was caused by a bacterial infection was not accepted without a fight. Most experts believed that Helicobacter was a harmless commensal, infecting people who had ulcers for some other reason. In response, Marshall drank a culture of Helicobacter to prove that the bacteria could infect a healthy person and cause gastritis. The truth behind peptic ulcers was revealed; that is, very young children acquired the Helicobacter organism, leading to a chronic infection which caused a lifelong susceptibility to peptic ulcers. Marshall developed new treatments for the infection and diagnostic tests which allowed the hypothesis to be evaluated and proven. After 1994 Helicobacter was generally accepted as the cause of most gastroduodenal diseases including peptic ulcer and gastric cancer. As a result of this knowledge, treatment is a simple procedure, and stomach surgery has become a rarity.     

重组牛碱性成纤维细胞生长因子治疗口腔溃疡42例

目的研究重组牛碱性成纤维细胞生长因子对口腔溃疡的治疗效果。方法把84例口腔溃疡患者随机分成两组,治疗组42例,用重组牛碱性成纤维细胞生长因子局部喷洒口腔溃疡创面;对照组42例,采用常规治疗方法。结果治疗组4d有效率为97.6%,对照组4d有效率为78.6%,有显著性差异(P<0.05)。结论重组牛碱性成纤维细胞生长因子对口腔溃疡的治疗具有显著疗效。     

Acellular Dermal Matrix Used in Diabetic Foot Ulcers: Clinical Outcomes Supported by Biochemical and Histological Analyses

Diabetic foot ulcer (DFU) is a diabetes complication which greatly impacts the patient’s quality of life, often leading to amputation of the affected limb unless there is a timely and adequate management of the patient. DFUs have a high economic impact for the national health system. Data have indeed shown that DFUs are a major cause of hospitalization for patients with diabetes. Based on that, DFUs represent a very important challenge for the national health system. Especially in developed countries diabetic patients are increasing at a very high rate and as expected, also the incidence of DFUs is increasing due to longevity of diabetic patients in the western population. Herein, the surgical approach focused on the targeted use of the acellular dermal matrix has been integrated with biochemical and morphological/histological analyses to obtain evidence-based information on the mechanisms underlying tissue regeneration. In this research report, the clinical results indicated decreased postoperative wound infection levels and a short healing time, with a sound regeneration of tissues. Here we demonstrate that the key biomarkers of wound healing process are activated at gene expression level and also synthesis of collagen I, collagen III and elastin is prompted and modulated within the 28-day period of observation. These analyses were run on five patients treated with Integra^® sheet and five treated with the injectable matrix Integra^® Flowable, for cavitary lesions. In fact, clinical evaluation of improved healing was, for the first time, supported by biochemical and histological analyses. For these reasons, the present work opens a new scenario in DFUs treatment and follow-up, laying the foundation for a tailored protocol towards complete healing in severe pathological conditions.     

新型治疗胃酸类活性分子吡美拉唑的合成及临床前研究

以2,3-二甲基-4-氯-N-氧代吡啶为起始原料,经缩合反应、酯化反应、水解反应、氯化反应、氧化反应五步工序,以16%的总收率完成了吡美拉唑的合成。对小鼠的药理实验表明,其对胃溃疡有较好的愈合作用,急性毒性试验结果为MTD>5g/kg,对小鼠骨髓细胞无明显致畸作用。     

难治性胃溃疡组织中VEGF表达的检测及意义

目的研究血管内皮生长因子(VEGF)在消化性溃疡发病中的作用,探讨难治性胃溃疡的血管分子学机制。方法收集30例因难治性溃疡和并发穿孔等并发症而行胃大部切除的患者作为难治性溃疡组,取其溃疡周边和远处组织,同时收集30例首诊为胃溃疡且经胃镜证实的患者,取溃疡周边和远处组织与难治性胃溃疡组作对照进行研究。采用免疫组化法检测VEGF蛋白表达。结果难治性溃疡组周边区的VEGF阳性细胞数为36,远处区为55,对照组溃疡周边区和远处区的阳性细胞数分别为57和70,两组患者溃疡周边区和远处区VEGF阳性细胞数组间和组内比较差别均有显著性意义(P<0.01)。结论VEGF表达水平显著降低。     

小剂量奥曲肽治疗急性胰腺炎的临床研究

目的探讨小剂量奥曲肽治疗急性胰腺炎的疗效。方法 124例胰腺炎患者,随机分为治疗组60例,对照组64例,治疗组给予奥曲有肽0.1mg,加入10%葡萄糖100mL中静滴,每日2次;对照组给予西咪替丁、654-2治疗。结果治疗组58例治愈,2例无效,总有效率96%;对照组50例治愈,14例无效,总有效率78%;治疗组疗效明显高于对照组(P<0.05)。血、尿淀粉酶恢复正常时间、症状缓解时间治疗组快于对照组,差异明显(P<0.01),住院时间明显缩短(P<0.01)。结论小剂量奥曲肽治疗急性胰腺炎疗效显著,且具有缓解症状快,恢复进行时间早,较少发生水电解质紊乱,缩短住院天数等优点。     

白细胞介素-1B和肿瘤坏死因子-α基因多态性与胃溃疡、胃癌易感性的相关性

目的探讨人群中白细胞介素-1B(IL-1B)和肿瘤坏死因子-α(TNF-α)基因多态性与胃溃疡、胃癌易感性的相关性。方法选取幽门螺杆菌阳性的39例胃溃疡患者、35例胃癌患者和70名健康对照者,采用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)分析法检测该人群中IL-1B-511、TNF-A-308和TNF-A-857基因多态性。结果疾病组与对照组中IL-1B-511各基因型频率的分布差异无统计学意义。与对照组比较,胃溃疡组TNF-A-308各基因型的频率分布、TNF-A-857各基因型的频率分布以及胃癌组TNF-A-308各基因型的频率分布差异均有统计学意义。经Logistic回归分析,与携带TNF-A-308G/G者比较,携带TNF-A-308A/A者发生胃溃疡的危险性为OR=21.62(95%CI:2.07～226.13);与携带TNF-A-857C/C者比较,携带TNF-A-857T/T者发生胃溃疡的危险性为OR=5.37(95%CI:1.28～22.50);与携带TNF-A-308G/G者比较,携带TNF-A-308A/A者发生胃癌的危险性为OR=16.41(95%CI:1.62～116.55)。结论TNF-α基因多态性与胃溃疡、胃癌的易感性相关。     

Role of microRNAs in Pressure Ulcer Immune Response,Pathogenesis, and Treatment

Pressure ulcers are preventable, yet highly prevalent, chronic wounds that have significant patient morbidity and high healthcare costs. Like other chronic wounds, they are characterized by impaired wound healing due to dysregulated immune processes. This review will highlight key biochemical pathways in the pathogenesis of pressure injury and how this signaling leads to impaired wound healing. This review is the first to comprehensively describe the current literature on microRNA (miRNA, miR) regulation of pressure ulcer pathophysiology.